Does cortisone cause weight gain?

My sister has chronic back pain.  It’s now over a year since she had her last operation on her back.  The doctors have taken x-rays, and from those x-rays, they cannot see where the problem is.  To the specialist that did this operation, the operation has been successful.  She was waiting to go for a MRI.

Recently she went for the MRI and they have come up with diagnoses.  Now they need to treat her and find an effective method that she does not have to continually live in pain.

The doctor did mention treating her condition with cortisone.  The main concern that my sister has with regards to this treatment that it will cause her to gain weight.

When my sister asked me, does cortisone cause weight gain?  I lied to her and said no!!

A better understanding what cortisone is to give a brief description what it is.  Cortisone is a steroid that is closely related to a hormone that our body produces naturally in the adrenal gland.  This hormone is called cortisol.  Cortisol plays a role in metabolic regulation as well as the body’s fight or flight response.  Cortisone may have the same effects.

Doctors prescribe cortisone for a variety of inflammatory conditions to reduce the swelling, pain and discomfort of the patients.  Patients with asthma and other chronic conditions associated with inflammation may take this hormone for extended courses.  Cortisone is also used for the treatment of very bad eczema.  Treatment of eyes; and certain cancers.

What matters is how much of the steroid gets into the body. An asthma inhaler will deliver most of the steroid only to where it is needed; the tubes of the lungs. Eczema creams stay largely on the skin. In both cases very little steroid is absorbed into the rest of the body so side effects can be kept low. Steroid tablets or injections are different because the drug is absorbed and distributed throughout the body by those routes.

The main to minimize the side effects of cortisone it to keep the dose as low as possible.  There is a limit on how this can be done and still get the necessary benefits.

Side effects of taking cortisone orally are as follows:-

Stomach upsets, headache, dizziness, menstrual changes (irregular, delayed, absent periods), trouble with sleeping, increased appetite, or weight gain may occur.

This medication should not be used if you have certain medical conditions.  bleeding problems, history of blood clots, brittle bones (osteoporosis), diabetes, eye diseases (e.g., cataracts, glaucoma, herpes infection of the eye), heart problems (e.g., congestive heart failure), high blood pressure, other infections (e.g., tuberculosis, herpes), kidney disease, liver problems (e.g., cirrhosis), mental/mood conditions (e.g., psychosis, anxiety, depression), low blood minerals (e.g., low potassium or calcium), stomach/intestinal problems (e.g., ulcer, ulcerative colitis, diverticulitis), thyroid problems.

Side effects of cortisone injections are as follow:-

The injected cortisone can crystallize in the body.  These crystals can cause pain and inflammation that is worse than the problem that is actually being treated.

There could be some skin discoloration around the injection site, but this is not harmful.

Cortisone can increase sugar levels.  People with diabetes should closely monitor sugar levers for a day or two following a cortisone injection.

The injection site can become infected, but this is rare.

Some people have an allergic reaction to cortisone. This is rare as the cortisone is similar to the naturally hormone found in the body.  Some can have an allergic reaction to the local anesthetic which is added to the injection.

Doctors do not recommend cortisone injections for patients who have an existing infection, including skin infections and septic arthritis. In addition, cortisone injections may be inappropriate for patients who are taking blood thinners or who have broken bones.

Some patients may be concerned about weight gain and water retention from corticosteroid use. However, these side effects are common only for patients who take corticosteroid medications orally for an extended period of time.

When cortisone medication is injected into a joint, these side effects do not occur.

While doing this research, I really believed that I had lied to my sister when she asked me the question, does cortisone make a person fat, and my answer was no.  The doctors wanted to inject the cortisone in the effect site and that weight gain is typical of cortisone taking orally.

The good news for those that take cortisone orally, a person does not have to get fat because they taking cortisone orally.  There are certain things that one can do that will prevent weight gain.  Cortisone taking orally will increase appetite.

To stop gaining weight you will have to reduce your calorie intake and increase your physical activity.

The easiest way to eat fewer calories without feeling hungry is to fill up on high-fiber (whole-grain breads and cereals) and low-energy foods (such as fruit and vegetables) and to include a source of protein at each meal (lean meat, chicken, fish, and pulses).  Don’t be tempted to skip meals, especially breakfast, as you are likely to snack on high-fat/calorie foods instead.  Kick start your metabolism with a healthy breakfast such as porridge or another whole-grain breakfast cereal with lower-fat milk, or a poached egg on whole meal toast – this should keep you going until lunchtime.  For lunch, go for whole-grain sandwiches and lower-fat fillings such as chicken and salad, hummus or grilled vegetables.  Also good are baked potatoes with baked beans, which will provide you both fiber and protein.

It is worth keeping a simple food diary for a couple of days – not necessarily to “calorie count” but so that you can spot easy ways to cut back.

Drinks can also make a substantial contribution to calorie intake, and simply having a filter coffee instead of a latte, opting for diet drinks or water instead of standard soft drinks and cutting back on alcohol can all make a difference.

Use the diary to look at your eating patterns and identify the times when you eat most or are likely to snack on higher-calorie foods. If you continue to gain weight, it might be worth joining a slimming group to give you some support or asking your GP if you can be referred to a dietitian for more advice.

People with concerns about cortisone and their weight can discuss some strategies with their doctor or a nutritionist.  It may be helpful to measure meals and take other steps to regulate the amount of food eaten over the course of the day, and to eat several small meals instead of one or two large ones.  Some patients may need to cut back on certain foods while taking the medication.  Gentle exercise like yoga or swimming may help patients stay fit on cortisone without running the risk of incurring an injury.